Effects of Transcutaneous Electrical Nerve Stimulation with Taping on Wrist Spasticity, Strength, and Upper Extremity Function in Patients with Stroke: A Randomized Control Trial.

Objective: Six months after the onset of stroke, over 60% of patients experience upper limb dysfunction, with spasticity being a major contributor alongside muscle weakness. This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) with taping on wrist spasticity, strength, and upper extremity function in patients with stroke. Methods: In total, 40 patients with stroke were included and randomly divided into two groups: the TENS + taping (n = 20, age 52.4 ± 9.3 (range: 39 to 70)) and TENS (n = 20, age 53.5 ± 10.8 (range: 39 to 74)) groups. All subjects performed 30 sessions of task-related training, which included 10 min of postural control training and 20 min of task performance. Additionally, all subjects received TENS on the spastic muscle belly for 30 min before task-related training. In the TENS + taping group, taping was additionally applied to the forearm and wrist but not in the TENS group. The Modified Ashworth Scale was used to measure spasticity, and a handheld dynamometer was used to measure muscle strength. The Fugl-Meyer Assessment of Upper Extremity was used to evaluate the functional ability of the upper extremity. Results: In the TENS + taping group, spasticity and upper extremity function were significantly improved as compared to those in the TENS group (p < 0.05). However, no significant difference in muscle strength was observed between the two groups (p > 0.05). Conclusions: This study demonstrated that the combination of TENS and taping for spasticity and function of the upper extremity was more effective in relieving the spasticity than TENS alone. Therefore, we suggest this combination as an additional treatment for spasticity and function of the upper extremity.

Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial.

BACKGROUND: Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS: A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS: There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS: Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION: This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).

Effects of Online Mindful Somatic Psychoeducation Program on Mental Health During the COVID-19.

OBJECTIVE: This study aims to determine the effects of online mindful somatic psychoeducation program (o-MSP) on mental health in female university students during the coronavirus disease-2019 (COVID-19). METHODS: Thirty-eight female university students were randomly assigned to an intervention group (IG, n=19) or a control group (CG, n=19). IG received o-MSP for 2-hours per session, twice weekly for 4-weeks; CG maintained their usual daily routine for 4-weeks. Measurements were performed pre- and post-intervention to assess stress, anxiety, and social connectedness using Perceived Stress Scale, State-Trait Anxiety Inventory, and Social Connectedness Scale. A qualitative analysis of changes in soma and social connectedness, subjectification of the soma, and mind-body integration was conducted through online interviews. RESULTS: Regarding stress and social connectedness, there were no significant difference between the groups (p>0.05). However, significant differences were observed in the main effect of time of measurement and time×group interaction, with IG showing significant improvement post-intervention, unlike CG (p<0.05). Regarding anxiety, there were significant differences in the main effect of time of measurement, time×group interaction, and group factor (p<0.05). Post-intervention, CG did not show a significant change, while IG showed a significant decrease (p<0.05). Qualitative analysis revealed that participants experienced "changes in soma and social connectedness," "subjectification of soma-body," and "embodiment of mind-body integration," and reported improved mental health. CONCLUSION: The o-MSP effectively reduced stress and anxiety in female university students and improved social connectedness. This suggests that o-MSP can be used to manage the mental health of university students in various settings.

Reduction of Edema and Pain in Transcutaneous Electrical Nerve Stimulation Treated-Arthritic Rat.

Transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain or improve motor function in musculoskeletal and neurological disorders in the clinic. Although some studies have suggested electrotherapy as an intervention for edema, the effects and mechanisms of TENS on inflammation-induced edema remain unclear. Thus, we aimed to investigate the effects of TENS on arthritic pain with edema. 1% carrageenan was injected into the right tibiofemoral joint of 69 male Sprague-Dawley rats (200-250 g). After the development of arthritic pain, low-frequency (4-Hz, Low-TENS, n = 25) and high-frequency (100-Hz, High-TENS, n = 25) TENS with sub-motor threshold or placebo-TENS (n = 19) was applied for 20-min to medio-lateral part of the ipsilateral side. Weight bearing and knee-bend tests were used to assess pain-like behaviors. Also, we examined the size of edema and measured tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1ß) levels in the synovium by western blot. Eight rats in each of the two TENS groups were injected with Naloxone. Edema was reduced in the low- and high-frequency TENS groups at 6-h. TENS-treated rats showed reduced pain in the knee-bend test at 6-h. We observed decreased weight load shifts on the ipsilateral side in TENS groups. Naloxone reduced these effects. TNF-α and IL-1ß expression decreased in the synovial membrane at 6-h. These results suggest that low- and high-frequency TENS have acutely positive effects on inflammatory edema, with the management of arthritic pain and reduction in pro-inflammatory mediators. Therefore, Low-TENS and High-TENS may be useful in treating acute inflammatory pain and edema.

The effect of types of sensory feedback on the acquisition and retention of squat performance: A randomized, double-blind, controlled trial.

Various sensory feedback methods are considered important for motor learning, but the effect of each sensory feedback method on effective squat learning still needs to be clarified. This study aimed to investigate the effect of sensory feedback types on the acquisition and retention of a squat. A double-blinded, randomized controlled trial was carried out. Thirty-healthy people were recruited and randomly assigned to the visual feedback group (VFG = 10), tactile feedback group (TFG = 10), and control group (CG = 10). VFG received visual feedback through video data of the participant performing squats, and TFG received tactile feedback through manual contact with a physical therapist. Both groups received feedback on the movements that needed correction after each set was completed. CG maintained rest without receiving any feedback. The retro-reflexive marker, force plate, and electromyography were used to measure body angle, foot center of pressure (COP), and muscle activity. All assessments were measured to confirm a squat acquisition. VFG and TFG showed significant differences in neutral knee position (NKP), trunk forward lean (TFL), anterior knee displacement (AKD), and anteroposterior (AP) foot COP (p < 0.050). In addition, the acquisition was retained until 3 days later for NKP and a week later for TFL, AKD, and AP foot COP in VFG (p < 0.050), while the acquisition was not retained in TFG (p > 0.050). There was no statistically significant change in CG (p > 0.050). This study demonstrated that visual feedback positively affects the acquisition and retention of squats. Therefore, we recommend the use of visual feedback for squat acquisition and retention in exercise novices.

Self-stretching exercises with kinesio taping for management of chronic nonspecific neck pain in taxi drivers: A single-blind, randomized controlled trial.

OBJECTIVES: Taxi drivers experience chronic neck pain owing to their posture while driving. The aim of this study was to investigate the effect of self-stretching exercises with kinesio taping on pain, stress, pressure pain threshold (PPT), disability, cervical range of motion (CROM) in this population. DESIGN: A single-blind, randomized controlled trial SETTING: Forty-three taxi drivers with nonspecific chronic nonspecific neck pain were randomly assigned to experimental (n = 22) and control (n = 21) groups. METHODS: In the experimental group, self-stretching exercises were performed 3 times a day, 5 days per week, for 4 weeks, with kinesio taping applied while driving. In the control group, only kinesio taping was applied while driving for 4 weeks. Pain intensity, stress intensity, PPT, neck disability, and CROM were assessed pre-intervention, post-intervention, and at 4 weeks post-intervention. RESULTS: Significant time and group interactions were observed in pain intensity at rest (p = 0.048) and while driving (p = 0.001). In the experimental group, the Pre - Post - Follow-up mean (95% CI) was 4.41 (4.14 to 4.68) - 3.82 (3.57 to 4.07) - 3.78 (3.55 to 3.99). In the control group, the Pre - Post - Follow-up mean (95% CI) was 4.29 (4.01 to 4.56) - 3.86 (3.60 to 4.11) - 4.05 (3.82 to 4.27) for pain at rest. In the experimental group, the Pre - Post - Follow-up mean (95% CI) was 4.91 (4.63 to 5.19) - 4.00 (3.76 to 4.24) - 3.69 (3.69 to 4.22), while in the control group, the Pre - Post - Follow-up mean (95% CI) was 4.81 (4.53 to 5.09) - 4.38 (4.13 to 4.63) - 4.57 (4.30 to 4.85) for pain while driving. PPT on the right (p = 0.029) and left (p < 0.001) sides, and neck disability (p = 0.001) also showed significant time and group interactions. NDI was not clinically significant based on the minimum clinically important difference. All CROM showed significant time and group interactions (flexion, p = 0.008; right lateral flexion, p = 0.009; left lateral flexion, p = 0.004; right rotation, p = 0.001; left rotation, p = 0.001), except for extension. CONCLUSION: This study showed that self-stretching exercises with kinesio taping provided benefits over kinesio taping alone on pain intensity, PPT, disability, and CROM in taxi drivers with nonspecific chronic neck pain. CLINICAL TRIAL REGISTRATION: This study registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) on September 22, 2020 (KCT0005406).

Short-Term Effects of Centralization of the Glenohumeral Joint and Dynamic Humeral Centering on Shoulder Pain, Disability, and Grip Strength in Patients with Secondary Subacromial Impingement Syndrome.

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain in adults and is caused by muscle imbalance around the shoulder joint, which is referred to as secondary SIS. Centralization of the glenohumeral joint (CGH), one of the intervention methods for this, targets strengthening the control ability of the rotator cuff. Dynamic humeral centering (DHC) targets the learning of selective contractile function of the pectoralis major and latissimus dorsi as depressors of the humeral head. This study aims to determine the short-term effects of CGH and DHC on pain, disability, and grip strength in patients with secondary SIS. Forty-eight patients with secondary SIS participated in the study and were randomly allocated into three groups (CGH group (n = 16), DHC group (n = 16), and simple exercise group (n = 16)) and received the intervention for 50 min. The Constant-Murley score was used to assess shoulder pain and disability (primary outcome), and a hand-held dynamometer was used to assess grip strength (secondary outcome). Measurements were performed before the intervention and one day after the intervention. The results showed that the Constant-Murley score improved in the CGH and DHC groups. In addition, pain and disability (range of motion scores) improved in both the CGH and DHC groups. Improvements in disability (shoulder strength) and grip strength were seen only in the CGH group. Both CGH and DHC can be used as methods for short-term pain release and disability recovery in secondary SIS. In particular, CGH appears to be more effective in the short-term improvement in shoulder strength and grip strength.

Effects of Plantar Flexor Stretching on Static and Dynamic Balance in Healthy Adults.

Stretching can affect balance ability by generating biomechanical and physiological changes in the postural muscles. Stretching of the lower extremity muscles can greatly affect posture maintenance strategies and balance ability. However, the relationship between stretching and balance ability has not been clarified. Therefore, this study aimed to investigate the effect of plantar flexor stretching on balance ability. Forty-four healthy young adults were randomly assigned to four groups (static stretching, dynamic stretching, ballistic stretching, and control). Ankle joint range of motion, static balance ability, and dynamic balance ability were evaluated before, immediately after, and 20 min after stretching. Stretching did not affect balance ability in the open-eye condition. After stretching, the sway area was significantly reduced in the closed-eye condition (p < 0.05). After stretching, the reach distance of dynamic balance ability increased significantly (p < 0.05). The results show that plantar flexor stretching can positively affect balance ability. Therefore, plantar flexor stretching should be considered a rehabilitation method to improve balance.

The Immediate Effects of Muscle Energy Technique in Chronic Low Back Pain Patients with Functional Leg Length Discrepancy: A Randomized and Placebo-Controlled Trial.

This study was conducted to determine the effect of muscle energy technique (MET) on pelvic alignment, leg length, pain, and fatigue in chronic low back pain (CLBP) patients with leg length discrepancy (LLD). Forty-two CLBP patients with LLD volunteered to participate and were randomly assigned to the MET group (n = 21) and placebo group (n = 21). The intervention group performed three METs with 5 s of isometric contraction and 30 s of rest once, and the placebo group performed three times the placebo-MET, maintaining the same posture as the MET group without muscle isometric contraction. X-ray equipment, tape measure, and visual analog scale were used to evaluate pelvic alignment, leg length, pain, and fatigue before and after each intervention. In comparison pre- and postintervention, only the MET group showed significant changes in pelvic alignment, leg length, pain, and fatigue (p < 0.05). In comparison between groups, there were significant differences in all variables (pelvic alignment, leg length, pain, fatigue) (p < 0.05). The results of this study confirmed the therapeutic effect of MET for improving pelvic alignment, functional LLD, pain, and fatigue in CLBP patients with functional LLD. Future research is needed to evaluate the long-term effect on more chronic low back pain patients.

Effects of a Traction Device for Head Weight Reduction and Neutral Alignment during Sedentary Visual Display Terminal (VDT) Work on Postural Alignment, Muscle Properties, Hemodynamics, Preference, and Working Memory Performance.

The forward head posture of visual display terminal (VDT) users induces various physical and cognitive clinical symptoms. However, few studies have been conducted to identify and solve problems associated with VDT posture. This study aimed to examine the adverse effects of VDT posture and the positive effects of traction-combined workstations by measuring postural alignment, muscle properties, blood velocity, preference, and working memory. Thirty-four healthy VDT users (18 males and 16 females aged 20-30 years) participated in the experiment at three workstations, including conventional (VDT_C), head support (VDT_S), and upright (VDT_U) workstations. They conducted 2-back working memory task. The craniovertebral angle (CVA), muscle tone and stiffness, blood velocity and visual analogue discomfort scale (VADS) were measured to examine the influence of workstations. VDT_C showed increased muscle tone or stiffness in the levator scapulae (LS), suboccipital muscle (SM), and sternocleidomastoid muscle (SCM) and an increased reaction time (RT) in working memory. However, VDT_S showed decreased stiffness and tone of SM and improved comfort. In addition, VDT_U showed decreased stiffness or tone of the LS and SCM and improved blood velocity and RT. In conclusion, maintaining neutral alignment significantly improved working memory performance, muscle properties, and blood velocity.

Investigation of Structural Changes in Rectus Abdominis Muscle According to Curl-Up Angle Using Ultrasound with an Extended Field of View.

The rectus abdominis (RA) muscle is related to abdominal muscle contraction and is divided into three sub-sections. In this study, changes in each section according to the curl-up angles were measured using ultrasound with an extended field of view (EFOV) scan and compared with the conventional scan. The results showed that the locations of the measurement position center were consistently detected only with the EFOV scan and that the change ratios in thickness and length between sections at the same angles were not significantly different, suggesting that each section was selectively activated. Furthermore, the ratios of the thickness and length changes in each section were significantly different between the rest position and curl-up angles. Specifically, in the section 2 there was a significant difference in the thickness and length changes between different angles, reflecting the characteristics of RA during contraction, and their variations were less than in the section 3. Therefore, the results suggest that changes in only a section of RA cannot be representative of overall RA activation, EFOV scan method can be useful for investigating the structural characteristics of RA in detail, and the proposed method can obtain various information about muscle contraction for efficient muscle treatment and muscle strengthening.

Influence of Loads and Loading Position on the Muscle Activity of the Trunk and Lower Extremity during Squat Exercise.

This study aimed to investigate the effect of the load and bar position on trunk and lower extremity muscle activity during squat exercise. High bar back squats (HBBS) and low bar back squats (LBBS) were performed in random order at 50%, 60%, and 70% loads of one repetition maximum by 28 experienced healthy adult men who had been performing squats for at least one year. Before the experiment, the maximal voluntary contraction of the vastus medialis, vastus lateralis, rectus femoris, biceps femoris, rectus abdominis, transverse abdominis, external oblique, and erector spinae muscles was measured by means of surface electromyography. In addition, eccentric and concentric exercises were performed for 3 s each to measure the muscle activity. There was a significant difference in muscle activity according to the load for all muscles in the eccentric and concentric phases (p < 0.05), indicating that muscle activity increased as the load increased. In addition, in the comparison between HBBS and LBBS, significant differences were shown in all lower extremity muscles and all trunk muscles except for the external oblique in the concentric phase according to the bar position (p < 0.05). HBBS showed a higher muscle activity of the lower extremity in the eccentric and concentric phases than in LBBS, while LBBS showed a higher muscle activity of the trunk muscle in the eccentric and concentric phases than in HBBS (p < 0.05). HBBS requires more force in the lower extremity than LBBS and is particularly advantageous in strengthening the muscular strength of the quadriceps. In contrast, LBBS requires more muscle activity in the trunk than HBBS and is more effective in carrying heavier loads because of the advantage of body stability. This study suggests that rehabilitation experts apply the bar position and load as important variables affecting the intensity and method of training for target muscle strengthening of the lower extremities and trunk.

Corrigendum to "Effectiveness of Transcutaneous Electrical Nerve Stimulation with Taping for Stroke Rehabilitation".

[This corrects the article DOI: 10.1155/2021/9912094.].

The Effects of Meditation with Stabilization Exercise in Marine Region on Pain, Tactile Sense, Muscle Characteristics and Strength, Balance, Quality of Life, and Depression in Female Family Caregivers of People with Severe Physical Disabilities: A Randomized Single-Blinded Controlled Pilot Study.

Female caregivers of people with disabilities are burdened physically and mentally. To improve these symptoms, an intervention that is easy to apply and has fewer side effects, such as natural healing, has been proposed, but the effect of healing using marine resources is unclear until now. The purpose of this study is to investigate the effect of meditation accompanied with stabilization exercise in the marine region on the improvement of pain, tactile sense, muscle characteristics, muscle strength, balance, quality of life, and depression in female caregivers of people with severe physical disabilities. Twenty-four female family caregivers were recruited and were randomly assigned to the marine therapy group (MTG, n = 12) and the control group (CG, n = 12). Both groups performed the same meditation (35 min) and stabilization exercise (25 min) twice a day for 3 nights and 4 days per session (total 8 sessions). The MTG performed these in the marine region, whereas the CG performed the interventions in the urban region. Pain (pain intensity and pain pressure threshold), tactile sense (tactile spatial acuity), muscle characteristics (stiffness, elasticity), muscle strength (hand and pinch grip strength), balance, quality of life, and depression were measured before and after the intervention and 4 weeks after the intervention. Both groups showed significant improvements in pain intensity (resting pain: f(2) = 72.719, p < 0.001; movement pain: f(2) = 24.952, p < 0.001), muscle strength (right pinch grip: f(2) = 15.265, p < 0.001), and depression (f(2) = 13.312, p < 0.001), while tactile spatial acuity (TSA) (upper part: f(2) = 14.460, p < 0.001; lower part: f(2) = 7.672, p = 0.002), dynamic balance (f(2) = 4.196, p = 0.024), and quality of life (overall quality of life & general health: f(2) = 5.443, p = 0.009; physical health: f(2) = 13.991, p < 0.001; psychological: f(2) = 9.946, p < 0.001; environmental: f(2) = 20.004, p < 0.001; total: f(2) = 11.958, p < 0.001) were significantly improved only in MTG. There was no significant change in pain pressure threshold (upper trapezius (UT): f(2) = 0.765, p = 0.473; levator scapula (LS): f(2) = 0.213, p = 0.809; splenius capitis (SC): f(2) = 0.186, p = 0.831) and muscle characteristics (UT stiffness: f(2) = 1.486, p = 0.241; UT elasticity: f(2) = 0.358, p = 0.702; LS stiffness: f(2) = 2.440, p = 0.102; LS elasticity: f(2) = 0.544, p = 0.585) in both groups. In comparison between groups, the MTG showed a significant difference in sensory function compared to the CG (resting pain: f(2) = 10.487, p = 0.005; lower part: f(2) = 5.341, p = 0.034 in TSA). Our findings suggest that meditation combined with stabilization exercise improved pain, muscle strength, and depression of female caregivers. In particular, greater benefits on tactile sense, balance, and quality of life were found in performing these in the marine region compared to the urban region.

Effects of Forest Healing Anti-Aging Program on Psychological, Physiological, and Physical Health of Older People with Mild Cognitive Impairment.

This study aimed to determine the effect of a forest healing anti-aging program on psychological, physiological, and physical health in older people with mild cognitive impairment (MCI). Twenty-two older people with MCI living in the city participated in a forest healing anti-aging program. Psychological indicators included the mini-mental state examination (MMSE), Beck depression inventory (BDI), profile of mood states (POMS), World Health Organization Quality of Life instrument (WHOQOL), and the Pittsburgh sleep quality index (PSQI). Physiological indicators included vital signs, body composition, and blood analysis. Physical indicators included the senior fitness test (SFT), muscle strength, spatiotemporal parameter of gait, static balance, and dynamic balance. Psychological, physiological, and physical indicators were evaluated at first and second pre-measurement, post-measurement, and one-month follow-up. MMSE, BDI, POMS, WHOQOL, body composition, blood analysis, SFT, muscle strength, spatiotemporal parameter of gait, and dynamic balance were significantly different between pre- and post-measurement. Beck depression inventory, POMS, WHOQOL, PSQI, SFT, muscle strength (elbow flexor muscle, knee extensor muscle), spatiotemporal parameter of gait significantly improved continually until the one-month follow-up. In conclusion, the forest healing program had a positive effect on the psychological, physiological, and physical health of older people with MCI.

Impact of Types of Breathing on Static Balance Ability in Healthy Adults.

Recent studies have suggested that breathing type may affect balance ability. However, most of these studies were conducted on the elderly and patients with musculoskeletal or neurological disorders. Therefore, the effect of voluntary breathing, such as thoracic and abdominal breathing, on the balance ability of people in various age groups is not clearly understood. The purpose of this study was to investigate the differences in balance ability according to the type of breathing in healthy young adults. This study included 78 healthy, young adults. All subjects were assessed for balance ability in neutral breathing, thoracic breathing, and abdominal breathing through a crossover design. Balance ability was assessed during static standing using a force plate. Participants were trained in voluntary breathing, evaluated using electromyography. During voluntary breathing, sway velocity, anterior-posterior difference, and anterior-posterior standard deviation increased while anterior-posterior sample entropy decreased compared to neutral breathing (p < 0.05). Compared with thoracic breathing, abdominal breathing increased sway velocity and variability, and reduced complexity (p < 0.05). These findings show that balance ability is affected by breathing, even in healthy young adults.

Effects of Pelvic Stabilization Training with Lateral and Posterior Tilt Taping on Pelvic Inclination, Muscle Strength, and Gait Function in Patients with Stroke: A Randomized Controlled Study.

Background: This study was aimed at investigating the effect of pelvic tilt taping on muscle strength, pelvic inclination, and gait function in patients with stroke. Methods: A total of 60 patients with stroke were included in our study and randomly divided into three groups: the posterior pelvic tilt taping (PPTT, n = 20), the lateral pelvic tilt taping (LPPP) with PPTT (LPPP+PPTT, n = 20), and the control (n = 20) groups. All participants performed pelvic stabilization exercises consisting of 6 movements: supine, side lying, quadruped, sitting, squatting, and standing (30 min/day, five days/week, for six weeks). PPTT to correct anterior pelvic tilt was applied to the LPTT+PPTT and PPTT groups, and lateral pelvic tilt taping was additionally applied to the LPTT+PPTT group. LPTT was performed to correct the pelvis tilted to the affected side, and PPTT was performed to correct the anterior pelvic tilt. The control group did not undergo taping. A hand-held dynamometer was used to measure the hip abductor muscle strength. In addition, a palpation meter and 10-meter walk test were used to assess pelvic inclination and gait function. Results: Muscle strength was significantly stronger in the LPTT+PPTT group than in the other two groups (p = 0.01). The anterior pelvic tilt was significantly improved in the taping group compared to the control group (p < 0.001), and the lateral pelvic tilt was significantly improved in the LPTT+PPTT group compared to the other two groups (p < 0.001). Significantly greater improvements in gait speed were observed in the LPTT+PPTT group than in the other two groups (p = 0.02). Conclusions: PPPT can significantly affect pelvic alignment and walking speed in patients with stroke, and the additional application of LPTT can further strengthen these effects. Therefore, we suggest using taping as an auxiliary therapeutic-intervention method in postural control training.

Development of a novel model of intervertebral disc degeneration by the intradiscal application of monosodium iodoacetate (MIA) in rat.

BACKGROUND CONTEXT: Low back pain is one of the most common musculoskeletal disorders. Although, the pathology of intervertebral disc (IVD) degeneration has been modeled using various biological methods, these models are inadequate for simulating similar pathologic states in humans. PURPOSE: This study investigated whether monosodium iodoacetate (MIA) injection into the IVD of rats could generate a reliable model of IVD degeneration. STUDY DESIGN/SETTINGS: In vivo animal study. METHODS: MIA was injected into two-disc spaces (L4-5 and L5-6) of Sprague-Dawley rats. Their behaviors were examined by measuring weight load shifts from hind to forefoot, rearing, and von Frey tests. We examined the inhibition of pain behavior through intraperitoneal morphine injection and measured cyclooxygenase-2 (COX-2) and transcription factor nuclear factor-kappa B (NF-κB) levels in the IVD and dorsal root ganglion (DRG) by Western blot. Bone alterations were assessed by microfocus computed tomography (micro-CT), and IVD and/or cartilage changes were evaluated by hematoxylin and eosin and safranin-O staining and inducible nitric oxide synthase (iNOS) immunohistochemistry. The other authors declare no conflicts of interest. This project funded by the Memorial Fund and the National Research Foundation of Korea (NRF). RESULTS: We observed increased weight load shifts to the forefoot and decreased rearing. Morphine-injected rats showed reduced pain. NF-κB and COX-2 expression increased in the IVD and left and/or right DRG. Micro-CT analyses suggested progressive bone deformation. Histologic examination showed decreased IVD width and nucleus pulposus area. Cartilaginous changes indicated epiphyseal growth plate loss. Finally, iNOS expression was increased in the subchondral endplate. CONCLUSIONS: These results suggest that low back pain (LBP) models can be developed by MIA injection into the IVDs of rats and that an animal model is useful for exploring degenerative alterations in the affected discs. Therefore, MIA injection may be a useful model for the study of changes in the IVD to elucidate the mechanisms underlying clinical symptoms, such as LBP, in patients with IVD degeneration. CLINICAL SIGNIFICANCE: This model in which MIA was injected into the disc better represented the human histologic and behavioral characteristics than the existing puncture model.

Effectiveness of Transcutaneous Electrical Nerve Stimulation with Taping for Stroke Rehabilitation.

BACKGROUND: Spasticity is a factor that impairs the independent functional ability of stroke patients, and noninvasive methods such as electrical stimulation or taping have been reported to have antispastic effects. The purpose of this study was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) combined with taping on spasticity, muscle strength, and gait ability in stroke patients. METHODS: From July to October 2020, 46 stroke patients with moderate spasticity in the plantar flexors participated and were randomly assigned to the TENS group (n = 23) and the TENS+taping group (n = 23). All subjects performed a total of 30 sessions of functional training for 30 min/session, 5 days/week, for 6 weeks. For therapeutic exercise, sit-to-standing, indoor walking, and stair walking were performed for 10 min each. In addition, all participants in both groups received TENS stimulation around the peroneal nerve for 30 min before performing functional training. In the TENS+taping group, taping was additionally applied to the feet, ankles, and shin area after TENS, and the taping was replaced once a day. The composite spasticity score and handheld dynamometer measurements were used to assess the intensity of spasticity and muscle strength, respectively. Gait ability was measured using a 10 m walk test. RESULTS: The spasticity score and muscle strength were significantly improved in the TENS+taping group compared to those in the TENS group (p < 0.05). A significant improvement in gait speed was observed in the TENS+taping group relative to that in the TENS group (p < 0.05). CONCLUSIONS: Thus, TENS combined with taping may be useful in improving spasticity, muscle strength, and gait ability in stroke patients. Based on these results, an additional application of taping could be used to enhance the antispastic effect of TENS or other electrical stimulation treatments in the clinic. A long-term follow-up study is needed to determine whether the spasticity relieving effect persists after taping is removed.

Microneedle Array Electrode-Based Wearable EMG System for Detection of Driver Drowsiness through Steering Wheel Grip.

Driver drowsiness is a major cause of fatal accidents throughout the world. Recently, some studies have investigated steering wheel grip force-based alternative methods for detecting driver drowsiness. In this study, a driver drowsiness detection system was developed by investigating the electromyography (EMG) signal of the muscles involved in steering wheel grip during driving. The EMG signal was measured from the forearm position of the driver during a one-hour interactive driving task. Additionally, the participant's drowsiness level was also measured to investigate the relationship between muscle activity and driver's drowsiness level. Frequency domain analysis was performed using the short-time Fourier transform (STFT) and spectrogram to assess the frequency response of the resultant signal. An EMG signal magnitude-based driver drowsiness detection and alertness algorithm is also proposed. The algorithm detects weak muscle activity by detecting the fall in EMG signal magnitude due to an increase in driver drowsiness. The previously presented microneedle electrode (MNE) was used to acquire the EMG signal and compared with the signal obtained using silver-silver chloride (Ag/AgCl) wet electrodes. The results indicated that during the driving task, participants' drowsiness level increased while the activity of the muscles involved in steering wheel grip decreased concurrently over time. Frequency domain analysis showed that the frequency components shifted from the high to low-frequency spectrum during the one-hour driving task. The proposed algorithm showed good performance for the detection of low muscle activity in real time. MNE showed highly comparable results with dry Ag/AgCl electrodes, which confirm its use for EMG signal monitoring. The overall results indicate that the presented method has good potential to be used as a driver's drowsiness detection and alertness system.